News & Updates

Saving Lives – Preventing Heart Failure in Kidney Disease

Worldwide, up to 40 per cent of people die from a cardiovascular cause following a kidney transplant. Research conducted right here in Adelaide could help change practice across the globe to improve this frightening statistic!

Based between the Royal Adelaide Hospital and the Lyell McEwin Hospital, Nephrologist Dr Nitesh Rao has joined forces with Professor Toby Coates, working on a project demonstrating potentially lifesaving results for those who’ve gone through dialysis and received a kidney transplant.

When a patient undergoes dialysis, a fistula is created in their arm, meaning two blood vessels are connected. During dialysis, two needles are inserted and blood is taken out and filtered through a machine that cleans the blood, before it is given back to patients.

“The issue is these patients proceed to have a kidney transplant and many times the fistula is left behind thinking it may be required in the future if the kidneys fail again,” Dr Rao said.

“Our study looked at the possible effects of leaving the fistula in the patient over a six-month period. One of our concerns with this is whether it’s putting extra strain on the heart.

“We completed a randomised trial and recruited over 60 patients, splitting them into two groups, with half the patients having their fistulas closed and the other half keeping theirs in.”

Teaming up with the cardiac unit at the RAH, both groups underwent cardiac MRI scans on their hearts at recruitment and six months following the intervention and their results were remarkable.

“The results were quite exciting for us as the patients who had their fistulas closed showed better cardiac results with their heart beginning to return to normal size and shape even within the short time span of six months,” Dr Rao said.

“Those patients who still had the fistula in had alteration in their heart structure due to high volume of the blood in the circulation as a result of the fistula. This can lead to cardiac problems including an increased risk of heart failure, which may be life-threatening for those people.”

This exciting outcome could potentially minimise the risk of heart disease for those patients who’ve received a kidney transplant, saving more lives!

The results of this study have gained worldwide attention. In May this year Dr Rao and Prof Coates presented their study at the Transplant Society of Australia and New Zealand in Melbourne which was extremely well received. They have also been accepted to present in San Diego this October at the American Society of Nephrology conference.

“We are hoping to publish the study in one of the major journals as few studies in medicine have shown the amount of change in a short amount of time that we have observed.

“This study is very exciting and has the potential to save lives. I’m very grateful to have received funding from KTDRA and The Hospital Research Foundation and look forward to continuing my work in this area.”